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Dual biologic or small molecule therapy may benefit highly selected, refractory inflammatory bowel disease (IBD) patients at specialized centers, a meta-analysis suggested.
In a review of 30 studies reporting on 288 trials, Robert Battat, MD, of Weill Cornell Medicine in New York City and colleagues found pooled clinical and endoscopic remission rates of 58.8% (95% CI 42-74.5) for dual biologic therapy and 34.3% (95% CI 23.5-46.1) for small molecule therapy.
In the study, online in
Clinical Gastroenterology and Hepatology, the pooled endoscopic response rate was 42.9% (95% CI 26.9-59.6) and the pooled extra-intestinal manifestations (EIMs) response rate in patients with baseline activity was 49.9% (95% CI 14.2-85.7).
Furthermore, the vast majority of these refractory patients were able to avoid surgery, with just 12% (95% CI 4-24) requiring operations. The rates of success were higher in patients on dual therapy for EIMs, the team noted.
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Both the Mediterranean diet and the Specific Carbohydrate diet were effective for symptom reduction in patients with Crohn s disease, a randomized clinical trial demonstrated.
At week 6, symptomatic remission was achieved by 44% of patients on the Mediterranean diet and by 47% of those following the Specific Carbohydrate diet, reported James D. Lewis, MD, of the University of Pennsylvania in Philadelphia at the virtual Crohn s and Colitis Congress.
And clinical remission defined by the Crohn s Disease Activity Index also was observed in similar numbers, at 48% for the Mediterranean diet and 49% for the Specific Carbohydrate diet.